Healthy Habits,  Science

ITBand or Iliotibial Band Syndrome in Runners.

So in my previous blog post I commented on having ITB syndrome, it’s quite a misunderstood injury as my initial thought after feeling pain was that I was developing runners knee or something like that, as a new runner I was not educated in all the various injuries that you could develop. All I know was I was I having fun and my body was reacting really well to the running, – I wanted to go faster –further and push myself more and more every day.

This could have been why I developed the injury – all I knew was I didn’t want to stop!

I did my first 21 km only 3 weeks after starting running – I was certainly fit enough – but I wasn’t really aware of what I was getting myself into – So I ran 10 km, really well and really fast, I lost my running partner and was in such haste looking for her that I didn’t realize how fast I was running – and then after a while I was exhausted, with the last 11km I tried to pace myself, and then with the last 5km I had to stop – my knee was hurting so bad, my muscles started to get cold but I wanted to finish and I did – in like 2:46 hours, lol that was kinda long..

So I met up with my running partner at her house afterwards, she is much more experienced runner than me and she explained to me what it could be, so she explained to me in very short what ITB syndrome was, I wanted to cry. Why couldn’t I just run – it felt like my body was betraying me…

I thought it was over – I tried everything to fix it until my doctor basically told me to take it easy and rest for 3 – 6 weeks, depending on the severity, I couldn’t climb stairs!! I was so upset… I got cortisone injections to help with recovery and was told that it will most likely make me pic up weight…. Yay, I exercised so hard just to get injured and fat again!

So I quit the whole winter – think it was more than 6 weeks, in the meantime I did some research.

I read so many articles, and did so many stretches and exercises – I found a very good article by Running writings. It follows ITB very closely and it has very good resources. Most of the information I got from here, so please have a look at it for more information. They did some studies as well, which is very interesting to read. To follow to the article click here

Have a look at the below image, it gives a good visual on where you feel pain:

Iliotibial Band Syndrome (ITBS), liac crest, Gluteus medius, Tensor fascia latae, Gluteus maximus,Vastus lateralis, Iliotibial band, Tibia tubercle, Patella, Inflammation of the iliotibial band (ITB) causes outer knee pain and possible pain in the hip, MendMeShop TM ©2011

ITBand syndrome usually starts bothering you at the outside of your knee, on the side – it can be easily mistaken as knee pain if you don’t know of any better, it usually begins with a slight pain gradually becoming worse – to the point where you might not be able to bend your knee, I could walk fine, but not bend my knee – not even climb stairs. Is was very painfull to the point where other body parts started to become sore for trying to compensate for the other injury.

At first I thought I just needed rest after my first 21km, but it didn’t work, every time I would try to run it would come back, immediately. I felt very discouraged…

From my Research I could basically see that I needed to make the rest of my body stronger – not just my legs , it was literally about my hips, gluts, and the most difficult for me, my abs…

So this is what I understand: ITB is basically the muscle band that connects your knee to your hip, and when your hips are not stable then it creates friction where the band connects over the knee, I’ve seen images where peoples knees are actually swollen, luckily for me that has not happened.

So have a look at the image below – also from this article , it is the best way to explain it:

In the picture you can see the one figure with hips balanced and stabilized – and the second with hips tilted – Pay a bit of attention when you walk or run, the moment your hips are un-stabilized it creates friction at the knee – aggravating the band. It is a condition that surfaces by runners on any level of expertise, beginner, intermediate or even professional. I believe the moment your body and legs get tired you tend to do funny things to compensate for being tired, running downhill will definitely effect your foot-strike to the ground, and this can actually change the movement within your hips in turn aggravating your ITBand.

I believe in NOT running downhill – everything I’ve learnt, read and even felt whilst running tells me that it’s not a good idea, go up hill, its more rewarding in the end!

SO the more your hips ‘dip’ side to side, and the more your knee flexes in increases the ‘pulling’ of the band, creating friction at the knee. Funny enough the article states that running faster is less stressful on the knee, because you knee flexes less when your foot strikes the ground. And this I definitely true, the other day I went for a run, not too fast, bit the moment I felt me ITBand start burning, I was just like – “NO! – go away” –  and I went faster as if to show it who’s the boss, lol, and it did actually went away, So go faster!

But ITBand can also be caused by a number of things – in the article they have a list, see below:

  1. Leg length differences
  2. Road camber – running on a slope for a long time
  3. Foot structure
  4. Excessive shoe breakdown – particularly it the outside of the heel
  5. Training intensity errors – increasing mileage or intensity too fast
  6. Muscle imbalances – particularly quads versus hamstrings
  7. Run/gait style factors – e.g. bow-leggedness, knock knees, etc.

One this I also read a while back was that it could be caused by constant running on the one side of the road – the road is basically more rundown at the sides so this in turn causes your one leg to run on a lower level than the other, destabilizing your hips, and aggravating your ITBand – not sure if this could be a main cause, but if you tend to get it in one knee only then this could be a contender for a reason why this is developing.

So how do we fix this?

Well it’s time to strengthen those bum and tummy muscles – this should help you to stabilize your hips, pay attention when running and if you notice that you dip your hips, try not to do it, try to get your form stable and

Force yourself to not dip while running, you’re not a Diva walking in 5 inch heels are you?

So keep our booty still!

The one thing that I have read that is important is to stretch, and to use a foam roller – I’ll post a blog tomorrow on the exercises that I found works best for me, but google it, Pinterest it.

Help is out there!

Remember the only thing that should dip, is a chip!

XOXOX – Jani



  • Bongani

    Thanks for the article, it was very informative for me and the problems I have experiencing since November last year Soweto Marathon. I went see a chiropractor that helped me in December and managed to 179km of training in that month but now in January after doing 52km in the 1st week my problem has started again which is very frustrating.

    • Jani du Toit

      Hi Bongani, I’m glad you liked the article. Its very difficult looking up injuries with all these big explanations and medical terms that normal people don’t usually understand. I’m happy that you found it informative. I have now Managed to keep my injury at bay atleast, good luck with yours. maybe take it easy for a while, I know it’s the worst thing hear. But get a foam roller do some stretching and strengthen you bum and tummy Mucels and run in the opposite side of the street that you usually run. Good luck!

    • Jani du Toit

      Hi Shane, I’ve done lost of your races before, I really enjoy them have a look here – Race Report: Trail Adventure – Family fun run Big Red Barn -

  • Jabs Zungu

    Wow Jani, thank you so much for such info, really helpful. I always try to explain to my running mates about this but now you’ve clearly explained it. I have a friend who’s been struggling with the pain on the knee, at first I thought it the type of shoe she is using but then she went to see a specialist who suggested a specific type but still, she would rest for a week or two then when she starts the pain comes back, what can you suggest?

    • Jani du Toit

      Hi Jabs, Glad you enjoyed the article.

      I’m not a doctor so any of the advise I give is just objective and what I purely think from research.
      The one thing that I have found that can benefit any runner in the long term with regards to injuries is strength training.
      I believe that injuries usually occur when a certain part of your body gets hurt because it has to compensate for another body part that is not strong enough to help.
      Resting to correct an injury can sometimes take longer than a week so she might have to rest longer – which I know very well we runners hate doing, but sometimes it is needed. if the pain is directly on the knee it could be her patella – Read this article about Runners knee, – – I think she needs to rest and maybe swap out the running for strength training to make her legs a little stronger, but read up on running injuries and the exercises you can do to prevent them.
      Also tread lightly when Google-ing injuries, and be smart and objective, sometimes there is a lot of silly advice out there.

      Hope She gets if fixed. I was out a whole winter with my ITB – and I still feel it some days, but then I just foam roll and do some tummy and bum exercises.

      Happy Running!

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